Monday, April 28, 2014

The Center for Health Innovation and Emergency Management Department sends our deepest sympathies to those affected by thetornadoes in AR, OK, and MO last night. As we type this, another set of tornadoes have touched down in the same general area.

Tornadoes are some of the worst of our natural disasters, as they have little warning and predictability. The current death toll from yesterday’s touchdown sits at 18 souls, a horrible number that may rise as the flattened debris is searched. But in the way tornado situations are observed, that number could have been much, much higher.

The areas impacted had a fighting chance.

It was not a weekday so students weren’t in school and after school activities, their parents weren’t driving home from work to meet them. It was also daylight as the first storms touched down around 5:30 p.m. local time. Finally, the areas that were hit are equipped with warning sirens. These three factors gave citizens a chance to get to their safe rooms or interior room/basement of their house. It did not save everyone, but those small factors helped to save lives.

It is often noted in news reports that we have never seen anything like this in “Tornado Alley.” This is unfortunately the new normal. Stronger and more frequent storms of all types, including predictable ones will continue to target our communities with reckless abandon. Everything that can be done should be done to ensure personal preparedness and community resiliency. By putting those types of measures in place gives you the ability to survive and thrive as communities in the new normal.

Monday, April 21, 2014

What would you do to live longer? Multiple studies have shown that extremely calorie restricted diets can extend our life spans; cut back to bare subsistence and you could add years to your life. Unfortunately, for most of us, human nature interferes. “We don’t want to go on that diet even if we know it’s good for us,” says Adelphi Assistant Professor of BiologyEugenia Villa-Cuesta, Ph.D. That’s where her research comes in.

For the past four years, Dr. Villa-Cuesta has been studying two drugs that can mimic the effects of dietary restriction: resveratrol and rapamycin.

Resveratrol, found in the skins of grapes, has been shown to be beneficial for cardiovascular disease and certain cancers. Rapamycin, on the other hand, is not found in food. “It’s actually produced by bacteria and found in soil,” says Dr. Villa-Cuesta. As a drug, it’s currently used as an immunosuppressant to lower the risk of organ rejection in transplant patients. Both compounds, however, have been shown to have possible effects on extending lifespan, and Dr. Villa-Cuesta’s research focuses on the mechanism by which they do this on the cellular level. “I found that resveratrol and rapamycin work similarly, affecting the same mechanisms in cells as calorie restriction,” she says.

To understand exactly how the compounds work in our cells, Dr. Villa-Cuesta and her lab test them in fruit flies. “They’re a great model organism,” she explains. “The pathways for these compounds within the cells are the same from fruit flies to humans.” Her research has also found that rapamycin increases the efficiency of mitochondria, the organelles within our cells that produce the energy for us to live.

While resveratrol is a health supplement anyone can currently buy over the counter, Dr. Villa- Cuesta cautions that we’re still a long way from a resveratrol/rapamycin life span extension regimen for humans. Still, she can’t help but be excited. “The potential of both as a treatment for increasing health is there,” she says.

Dr. Villa-Cuesta was recently published in the Journal of Cell Science, you can find the abstract andlinks here. This piece appeared in theErudition2013 edition.

Friday, April 18, 2014

Thanks to the local food movement, more people than ever are asking questions about how their food is grown and raised. But there’s one consideration that is almost always forgotten, says Margaret Gray, Ph.D., assistant professor of political science in the College of Arts and Sciences. “The locavore movement at its heart promotes a food ethic,” Dr. Gray continues, “but labor needs to be included in that equation.”

Part of the reason for this is a false dichotomy, says Dr. Gray. “We have this idea of ‘corporate industrial monoculture’: bad, ‘local mom and pop’: good. But there’s no inherent good or bad depending on the scale of the farm. Local is just geography. The same issues that we’re concerned about on large corporate farms, we should be concerned about on local farms, too, and consumers should be aware that the labor practices on small farms mirror the labor practices on large industrial farms.”

Dr. Gray’s research focuses on the Hudson Valley in upstate New York, one of the major sites of the local food movement in the United States. Starting in 2000, she began interviewing farmers, farm workers, advocates, legislators and lobbyists regarding labor practices on farms in the area.

“The vast majority of the industry workforce are noncitizen immigrants,” says Dr. Gray. “They are an extremely vulnerable workforce, and much of what I explore is how that vulnerability is related to the labor conditions and how their reluctance and fear change their situations.”

For example, Dr. Gray explains, farm workers in New York State do not share the same rights as other workers. “They have no right to overtime pay, no collective bargaining protections, no right to a day of rest.”

While there are campaigns at work to change this, Dr. Gray hopes her research, which will be published by the University of California Press in a forthcoming book entitled Labor and the Locavore, can also play a role in creating change. “I want to raise awareness,” she says. “When we’re buying food in farmers markets or at their CSA [community-supported agriculture program], we need to ask questions about labor conditions the same way we ask about pesticide usage and the way animals are treated.”

Tuesday, April 15, 2014

In his new book, Political Gastronomy: Food and Authority in the English Atlantic World, published in 2012 by the University of Pennsylvania Press, Adelphi College of Arts and Sciences Associate Professor of HistoryMichael LaCombe, Ph.D., focuses on the role of food in encounters between Native Americans and the English settlers in the United States between 1570 and 1640. “That’s the interesting period,” Dr. LaCombe says, laughing. “Once the English get things figured out, things get really boring.”

Among the early settlers’ food-related concerns were what effects, if any, new world foods would have on their health. “They believed in the four humors,” explains Dr. LaCombe. “Blood, phlegm, black bile and yellow bile. Certain foods were believed to have an effect on the balance of the humors, which they thought could make you sick. Cucumbers and tomatoes, for example, were suspicious because they were cold and moist, so many people thought they would make your body cold and moist.” Corn seemed to be of particular concern. “The settlers worried that if they ate this strange New World food, they would become Indian,” Dr. LaCombe says. “There are accounts of English babies born in the New World and families writing back to England noting with surprise and relief that the babies were ‘born white.’”

More than simply investigating the settlers’ experiences with food, Dr. LaCombe’s research looks at the way food established relationships between the English and Native Americans, in particular at shared meals. “I argue that all parties to these meals understood that there were meanings passing back and forth. When you sit down to table with somebody, this is an important occasion and your manners are being scrutinized.”

For example, sharing rare or high-status food was often a means of asserting superiority. “There’s a very common reference to a gift of venison at the first Thanksgiving,” Dr. LaCombe says. “With venison and other similar foods, the Native American leaders who arrive at Plymouth are in part trying to convey meaning relating to their own superiority and status.”

Thursday, April 10, 2014

Sandy was a devastating storm but ultimately not an unusual one, says Philip Alcabes, Ph.D., director of public health programs and a professor in the College of Nursing and Public Health. “That we face a new normal is suddenly self-evident,” he says. “Extreme weather is no longer unlikely, the once-in-a-blue-moon kind of thing, no longer extreme. The new environment portends big changes for the nation, of course, and especially for Long Island.”

Dr. Alcabes studies history, policy and ethics in public health, and believes that government officials and medical experts now need to consider climate change when designing public health systems. “If extreme weather threatens the energy supply, hospitals might run on generators, but what will happen to the increasing numbers of people with chronic conditions who are under treatment in their own homes—the so-called patient-centered medical home, advocated by family physicians and home healthcare, increasingly offered to older Americans?” Dr. Alcabes asks. “What will become of patients who are no longer in need of acute medical care but are marooned in medical centers because their homes— or entire neighborhoods—are uninhabitable?”

Global warming also creates two new tasks for academics, he says. The first is investigating how changing ecosystems, agriculture and transportation might impact human health. “How will specific alterations in the balance of potentially harmful and potentially helpful microbes translate into health and illness?” he says. “How will altered food supplies change our nutritional fortitude and thus our defenses against illness?”

The second task is training health professionals for a new era. “Sandy revealed that if we continue to devote resources to managing emergencies but fail to think more comprehensively about persistent community management problems, more people will suffer without heat or light or elevators or running water, and their misery will go on longer,” Dr. Alcabes says.

“Public health is not just about providing services to the vulnerable in the moment when they’re vulnerable,” he adds. “It’s about changing the social structures and having more responsible government officials so that people aren’t suffering all the time, and the people who are suffering most don’t end up suffering even more when there’s a disaster.”

How best to prepare students for a health career in a world where the environment is changing? Dr. Alcabes is working on one idea. He and colleagues in the environmental studies department at Adelphi are looking at developing an environmental health concentration within the Master’s of Public Health program.

Tuesday, April 8, 2014

Who can forget the stories of elderly people trapped on high floors of low-income buildings, unable to walk down flights of stairs to get the food, water and medication they needed following Sandy? It’s no coincidence that some of the most heart-wrenching tales of despair after the storm featured the elderly as well as the chronically ill, children, pregnant women and ethnic minorities, according to Joan Valas, R.N., Ph.D., chair of graduate studies and an associate professor at the College of Nursing and Public Health. “Things happen more extensively to vulnerable populations because they don’t have the ability to prepare, and they don’t have the social network [to help them],” she says.

Much of Dr. Valas’ scholarly research focuses on care for vulnerable and diverse populations during and after disasters. Her work indicates that one way to mitigate the suffering of vulnerable people during disasters is to provide better services for them during normal times.

Disasters expose ongoing suffering that’s usually hidden from view during calmer periods, she notes. “A disaster is a setting where vulnerabilities become very prominent,” she says. “Things that never get talked about, things that live in the shadows and are not discussed, all are on the front page of The New York Times and CNN after a disaster.”

Dr. Valas has certainly seen her fair share of disasters. As the emergency management director of Park Ridge, New Jersey, the town in which she lives, she has coordinated her community’s disaster response during five federally declared emergencies in the past six years, including Sandy, Hurricane Irene and several major snowstorms. She also treated injured people and patients with chronic illnesses in Mississippi and Louisiana after Hurricanes Katrina and Rita in 2005 as a volunteer supervisory nurse specialist/nurse practitioner with a DMAT.

While in the Gulf, she traveled with an armed guard after being attacked by a man desperate for the medical team’s drugs and visiting a neighborhood where a resident was shooting at strangers. “When you go into a disaster area like this, you’ve got to understand the amount of stress the people are under who’ve lost their homes,” she says. “You can’t imagine what it does to people inside when they’ve lost everything.”

Friday, April 4, 2014

Recent natural disasters such as the mudslide in Washington State, reports of tornadoes and the coming hurricane season reminds us about preparation, response, recovery and mitigation of further emergencies.

by Samantha Stainburn

Kenneth C. Rondello, M.D., M.P.H., the academic director of Adelphi’s emergency management program and an assistant professor in the College of Nursing and Public Health, knows that responding to disasters is an unpredictable business.

Dr. Rondello is always on call as a member of one of the federal government’s Disaster Medical Assistance Teams (DMAT), groups of 35 physicians, nurses and support personnel who are flown to regions of the country that are overwhelmed by disaster. DMATs, which can operate for 72 hours without support, provide primary and acute care and triage of mass casualties until local medical workers regain control of the situation. Dr. Rondello was deployed with his team to help after Hurricanes Gustav, Hanna and Ike in 2008 and a record-breaking flood in Tennessee in 2010.

“Disasters require you to adapt on the fly; it’s never routine,” he says. For nurses in a hospital, that might mean going to a different area of the building and doing work they don’t usually do. For emergency responders, that could mean transforming a gutted store into a temporary hospital, as Dr. Rondello’s team did in Texas after Hurricane Gustav.

But planning for disasters is still essential, he says. Dr. Rondello’s research interests include disaster epidemiology (using epidemiologic methods to assess the adverse health effects of disasters and predict consequences of future disasters), alternate medical treatment sites and distribution points, and epidemic and pandemic planning and response. To mitigate the consequences of any disaster, he says, it helps to map out the likely scenarios of different types of disasters and identify the people, property and environments that are most at risk in each scenario. “You can’t foretell all possibilities,” he says, “but for those you do identify, you need to be specific enough that you can plan for concrete action.”